纵隔卡波西型血管内皮瘤合并卡梅现象患儿的护理

doi:10.3761/j.issn.2096-7446.2023.07.014

中华急危重症护理杂志 ›› 2023, Vol. 4 ›› Issue (7): 635-638.doi: 10.3761/j.issn.2096-7446.2023.07.014

纵隔卡波西型血管内皮瘤合并卡梅现象患儿的护理

时家梅, 孙柔婷, 丁亚平, 夏姗姗

310000 杭州市国家儿童健康与疾病临床医学研究中心/浙江大学医学院附属儿童医院儿科重症监护室（时家梅,丁亚平,夏姗姗）; 浙江省人民医院心胸外科（孙柔婷）

收稿日期:2022-12-29 出版日期:2023-07-10 发布日期:2023-07-11
通讯作者: 夏姗姗,E-mail：xiashanshan@zju.edu.cn
作者简介:时家梅：女,本科,护师,E-mail：sjm18268087219@outlook.com
基金资助:
浙江省教育厅一般科研项目（Y202145940）

Nursing care of an infant with mediastinal Kaposiform hemangioendothelioma combined with Kasabach Merritt phenomenon

SHI Jiamei, SUN Routing, DING Yaping, XIA Shanshan

Received:2022-12-29 Online:2023-07-10 Published:2023-07-11

摘要/Abstract

摘要： 总结1例纵隔卡波西型血管内皮瘤合并卡梅现象患儿的护理体会。针对患儿血小板顽固性低下,采取严密观察出血倾向,重点预防颅内出血护理;针对纵隔肿物,提高病情警示级别,早期识别严重并发症;针对患儿疼痛,实施预见性疼痛护理;针对联合应用免疫抑制方案,加强用药护理,落实家长参与式护理,提升院外照护能力。入院40 d患儿血小板计数上升,凝血功能纠正,顺利出院。3个月后随访患儿病情稳定,纵隔占位较前缩小。

关键词: 卡波西型血管内皮瘤, 卡梅现象, 危重病护理

Abstract: To summarize the nursing experience of an infant with Kaposiform hemangioendothelioma of mediastinum combined with Kasabach Merritt phenomenon. In response to the stubborn low platelet count in the child,close observation of bleeding tendency was taken,with a focus on preventing intracranial hemorrhage. In view of the mass located in mediastinum,we improved the warning level of illness and identify serious complications early. Predictive pain care was carried out for the pain. In view of the combined application of immunosuppressive regimen,we strengthened medication nursing,implemented parents' participatory nursing and improved the ability of out-of-hospital care. The patient's platelet count increased,blood coagulation function was corrected 40 days after admission,and he was discharged smoothly. After three months,the patient was followed up in a stable condition. The mediastinal mass was smaller than before.

Key words: Kaposiform Haemangioendothelioma, Kasabach Merritt Phenomenon, Critical Care Nursing

时家梅, 孙柔婷, 丁亚平, 夏姗姗. 纵隔卡波西型血管内皮瘤合并卡梅现象患儿的护理[J]. 中华急危重症护理杂志, 2023, 4(7): 635-638.

SHI Jiamei, SUN Routing, DING Yaping, XIA Shanshan. Nursing care of an infant with mediastinal Kaposiform hemangioendothelioma combined with Kasabach Merritt phenomenon[J]. Chinese Journal of Emergency and Critical Care Nursing, 2023, 4(7): 635-638.

参考文献

[1] 羊樟福,胡博,付佩尧,等. 卡波西型血管内皮瘤诊疗进展[J]. 中国临床医学,2019,26(2):286-291.
Yang ZF,Hu B,Fu PY,et al.Progress in diagnosis and treatment of Kaposiform hemangioendothelioma[J]. Chin J Clin Med,2019,26(2):286-291.
[2] Croteau SE,Liang MG,Kozakewich HP,et al.Kaposiform hemangioendothelioma:atypical features and risks of Kasabach-Merritt phenomenon in 107 referrals[J]. J Pediatr,2013,162(1):142-147.
[3] Schmid I,Klenk AK,Sparber-Sauer M,et al.Kaposiform hemangioendothelioma in children:a benign vascular tumor with multiple treatment options[J]. World J Pediatr,2018,14(4):322-329.
[4] 张源方,董长宪. 卡波西样血管内皮瘤研究进展[J]. 中华实用儿科临床杂志,2018,33(11):874-877.
Zhang YF,Dong CX.Research progress of Kaposiform hemangioendothelioma[J]. Chin J Appl Clin Pediatr,2018,33(11):874-877.
[5] Yao W,Li KL,Qin ZP,et al.Standards of care for Kasabach-Merritt phenomenon in China[J]. World J Pediatr,2021,17(2):123-130.
[6] 陈小娟,叶枫,顾莹莹,等. 卡波西型血管内皮瘤1例报告并文献复习[J]. 中国实用内科杂志,2017,37(6):578-580.
Chen XJ,Ye F,Gu YY,et al.A case report of Kaposifrom hemangioendothelioma and literature review[J]. Chin J Pract Intern Med,2017,37(6):578-580.
[7] Duan L,Renzi S,Weidman D,et al.Sirolimus treatment of an infant with intrathoracic Kaposiform hemangioendothelioma complicated by life-threatening pleural and pericardial effusions[J]. J Pediatr Hematol Oncol,2020,42(1):74-78.
[8] Bhatacherya S,Roy P,Chatterjee U et al. Kaposiform hemangioendothelioma in anunusual site:A report of two cases in children[J]. Indian J Pathol Microbiol,2022.65(1):167-169.
[9] Ji Y,Chen SY,Yang KY,et al.Kaposiform hemangioendothelioma:current knowledge and future perspectives[J]. Orphanet J Rare Dis,2020,15(1):39.
[10] 沈巧,郑显兰,史源,等. 中国新生儿疼痛管理循证指南(2023年)[J]. 中国当代儿科杂志,2023,25(2):109-127.
Shen Q,Zheng XL,Shi Y,et al.Evidence-based guideline for neonatal pain management in China(2023)[J]. Chin J Contemp Pediatr,2023,25(2):109-127.
[11] 王漪檬,马爱玲,赵宁民,等. 儿童患者西罗莫司血药浓度监测及临床应用分析[J]. 儿科药学杂志,2022,28(1):10-13.
Wang YM,Ma AL,Zhao NM,et al.Blood concentration monitoring and clinical application of sirolimus in children[J]. J Pediatr Pharm,2022,28(1):10-13.
[12] 袁雅文,吴娟,沈安乐,等. 儿童长春新碱诱导周围神经病变的流行病学及危险因素研究[J]. 药物流行病学杂志,2022,31(11):720-724.
Yuan YW,Wu J,Shen AL,et al.Epidemiology and risk factors of vincristine-induced peripheral neuropathy in children[J]. Chin J Pharmacoepidemiol,2022,31(11):720-724.
[13] Kiersten W,Ricci. Coagulation issues in vascular anomalies[J]. Semin Pediatr Surg,2020,29(5):150966.
[14] 钱素云,陆国平,许峰,等. 危重症儿童营养评估及支持治疗指南(2018,中国,标准版)[J]. 中国循证儿科杂志,2018,13(1):1-29.
Qian SY,Lu GP,Xu F,et al.Guidelines for the provision and assessment of nutrition support therapy in critically ill children(2018,China,standard edition)[J]. Chin J Evid Based Pediatr,2018,13(1):1-29.
[15] 林楠,诸纪华,徐红贞,等. 早产儿体位管理的最佳证据总结[J]. 中华护理杂志,2022,57(4):486-492.
Lin N,Zhu JH,Xu HZ,et al.Best evidence summary of po-sitioning management for preterm infants[J]. Chin J Nurs,2022,57(4):486-492.
[16] 刘艳红,李胜玲,崔慧敏,等. 指导无创机械通气早产儿母亲实施袋鼠式护理对其亲职压力和育儿胜任感的影响[J]. 中华护理杂志,2022,57(22):2700-2707.
Liu YH,Li SL,Cui HM,et al.Effects of kangaroo mother care on the parenting pressure and parenting sense of competence of mothers of premature infants with non-invasive mechanical ventilation[J]. Chin J Nurs,2022,57(22):2700-2707.
[17] 臧舒婷,芦良花,韩涵,等. ICU患者发生医院感染与家属探视模式的相关因素分析[J]. 中华医院感染学杂志,2017,27(23):5501-5504.
Zang ST,Lu LH,Han H,et al.Analysis of related factors of nosocomial infections and family visit in ICU patients[J]. Chin J Nosocomiology,2017,27(23):5501-5504.

纵隔卡波西型血管内皮瘤合并卡梅现象患儿的护理

Nursing care of an infant with mediastinal Kaposiform hemangioendothelioma combined with Kasabach Merritt phenomenon

PDF下载

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	杨莉, 徐晓滨, 王华芬. 功能性近红外光谱在急危重症患者护理中的应用进展[J]. 中华急危重症护理杂志, 2026, 7(7): 836-840.
[2]	柳小婷, 王萍, 徐亦虹, 范婷婷, 付真真, 熊子菡, 何蓓蕾, 陈晓晖, 章晓明, 舒妍. 巨结肠类缘病术后并发超短肠综合征伴多造口患者的护理[J]. 中华急危重症护理杂志, 2026, 7(7): 849-851.
[3]	邵丽红, 李春艳, 董晓琪, 王巧琳, 叶国凤, 赵巧梅. 口腔多原发癌患者游离皮瓣移植术后多重严重并发症的护理[J]. 中华急危重症护理杂志, 2026, 7(7): 852-855.
[4]	张慧, 何雪花, 王莉, 宫晓艳, 庄一渝. 边缘供心心脏移植术后患者原发性移植物功能障碍的早期预警与护理[J]. 中华急危重症护理杂志, 2026, 7(6): 682-684.
[5]	曾妃. 家族性肥厚型心肌病合并肝功能衰竭患者行心肝同期联合移植的护理[J]. 中华急危重症护理杂志, 2026, 7(6): 685-688.
[6]	羊木英, 范文琪, 胡汉. 维持性血液透析患者透析中脑出血的早期识别与急救护理[J]. 中华急危重症护理杂志, 2026, 7(6): 704-706.
[7]	庄佳妮, 李小珍, 史超强, 王英, 谭丽萍. 颈深部感染致纵隔脓肿患者的围手术期护理[J]. 中华急危重症护理杂志, 2026, 7(6): 707-709.
[8]	李改乐, 潘文彦, 李菁菁, 刘霄, 唐颖嘉, 侯进. 肝移植患者术后并发耶氏肺孢子菌与巨细胞病毒感染的护理[J]. 中华急危重症护理杂志, 2026, 7(6): 710-713.
[9]	王燕, 卢芳燕, 刘元, 王芳. 进行性家族性肝内胆汁淤积症患儿行亲体肝移植的术后护理[J]. 中华急危重症护理杂志, 2026, 7(6): 714-716.
[10]	王淑君, 鲁虹言, 杨林娜. 《成人吸入性损伤气管切开术后气道内吸引技术》团体标准解读[J]. 中华急危重症护理杂志, 2026, 7(5): 569-573.
[11]	董莲莲, 罗雪莉, 魏文静, 陈玲欣, 任红艳, 宫晓艳. 硫胺素缺乏致湿性脚气病伴多器官功能损害患者的护理[J]. 中华急危重症护理杂志, 2026, 7(5): 591-594.
[12]	臧瑞津, 李玲玲, 郑苗, 钟娟平, 南锐伶, 王兴蕾, 豆欣蔓. 瞳孔测量在危重症患者疼痛评估中的应用进展[J]. 中华急危重症护理杂志, 2026, 7(5): 631-635.
[13]	徐峰, 章毅, 王秀玲, 潘丽丽, 诸纪华. 先天性无痛无汗症患儿合并脓毒症并发惊厥持续状态的护理[J]. 中华急危重症护理杂志, 2026, 7(4): 450-452.
[14]	孙春艳, 胡蕾. 神经源性直立性低血压合并仰卧位高血压患者的护理[J]. 中华急危重症护理杂志, 2026, 7(4): 456-458.
[15]	沈丹军, 诸纪华, 徐红贞, 冯佳艳, 郑虹, 叶飞亚, 盛美君. 兰尼碱受体2基因变异相关儿茶酚胺敏感性多形性室性心动过速患儿的护理[J]. 中华急危重症护理杂志, 2026, 7(3): 312-315.